I’m a clinical psychiatrist who’s been in private practice for over 25 years. I’m board certified, a distinguished fellow of the American Psychiatric Association and author of The New York Times bestseller “Better Than Normal”. I am also a serial entrepreneur and have founded businesses in fields as disparate as medicine, poker, diamonds, real estate and venture capital.
We are bombarded by a flood of undigested news bytes 24-7 that are pre-analyzed by “experts” from every conceivable angle, with ever-increasing complex explanations. In reality the underlying solution is often so much simpler.
The foundation for human behavior hasn’t changed for 100,000 years, and can reveal much about the vicissitudes of economics and business, as well as the true motivations of the policy makers who influence the marketplace. That’s why I use the lens of human behavior to analyze politics, companies and the economic news of the day.
I will explain how heuristics, framing, mimicry, loss aversion, anchoring, bounded rationality and other psychological factors keep us trapped in the ‘normal box’ of conventional thinking when it comes to deciphering what is going on around us. A firm understanding of psychology and human nature can help you see past the hype with respect to policy, running a business or making an investment decision.

ADHD: The High Price Of A Quick, Quick Fix

At long last, the scientific research community is rethinking a 20-year old study about the benefits of medicating ADHD with stimulants like Ritalin. The study, funded with $11 million from the National Institute of Mental Health, weighed the pros and cons of medication versus long-term behavioral therapy and skills training. The findings came down heavily in favor of medicating, arguing that pills trumped all other treatments, improving symptoms of the so-called disorder. Not only that, it found that adding any type of behavioral therapy offered no benefit to medication alone.

The landmark research was a multi-billion dollar gift to the pharmaceutical industry, which took those findings and ran a marathon with them. As I discuss in my column, “The Dark Side of Big Pharma”, stimulant sales have quintupled since 2002 to more than $8 billion in revenues. The number of children on medication for ADHD has grown to 3.5 million from 600,000 in 1990, according to the CDC, with a diagnosis in 15 percent of high-school age children when, in fact, the true rate is closer to 5 percent, with only a small minority of that group truly needing to be medicated.

Intensive marketing campaigns by Big Pharma, along with the rush to develop yet more variants of ADHD drug treatments, have contributed to this shameful state of over-diagnosis. So have stressed out parents and overworked teachers, whose classrooms are too full to offer alternative ways of learning better suited to those with ADHD traits. And all this pill pushing was done with the blessing of a legitimate research organization. It was the perfect storm.

Now the research community, including some authors of the study, have expressed concern that the benefits of medication have been overstated. According to a recent New York Times article, they now see that these oversold research results have “distorted the debate over the most effective (and cost-effective) treatments”.

Ya think? In my 25 years of practice in the field of psychiatry, I have come to understand that medication should only be a last resort, and even in those cases, people don’t need to be on these pills forever. But it has long been held that medication is oh so much easier in our pop-a-pill, immediate gratification culture.

Adderall (Photo credit: Wikipedia)

In a highly competitive environment where it superficially seems that it pays to conform and be “normal,” there’s a strikingly unhealthy tendency in the field of mental health to identify a set of “symptoms” as a “disease” in the hopes of finding a “cure”. This adversely affects the decision-making of parents, doctors, individuals, organizations, insurance companies and educators.

The experts are finally admitting that medication isn’t the most cost-efficient way of dealing with ADHD after all. More recent studies have called into question whether the benefits from a pill last as long as behavioral therapy coupled with techniques to improve long-term academic and social functioning. It’s hard to quantify the immense opportunity cost for a generations of kids, who should have been taught how to leverage their ADHD traits as a strength- not diagnosed with an un-curable condition that may require a life-time of medication.

The pendulum has swung too far, and must head the other way, before our entire society is on a psychiatric medication for something, be it moodiness, sadness, too little (or too much) energy, occasional anxiety or insomnia. Look, I’m not suggesting that in severe cases pharmacologic treatment for ADHD is not indicated but, based on the numbers, we’re medicating this like it’s an epidemic. It’s absurd.

What’s needed is a drastic shift in the way we diagnose, view and handle what is more of a distinctive personality type rather than a debilitating psychological condition. We need to understand that ADHD isn’t just something that flicks on and off like a switch. It exists along a continuum, on a scale from one to 10, and very few with the diagnosis have symptoms that are severe enough to merit the highest rating and hence require meds.

As we start the New Year, it’s time we recognize that, with the right skills training, education and awareness, some of the most common traits of ADHD – restlessness, curiosity, resilience (yep, here’s the study), an innate sense of adventure, and the ability to multitask—can be successfully leveraged as strengths.

Folks like Sir Richard Branson, JetBlue founder David Neeleman, and Cisco CEO John Chambers are not successful despite having ADHD, but because of it. Some of the world’s most famous entrepreneurs and success stories are driven by their ADHD traits, and who knows how many more companies could be created, or new worlds discovered, if these natural explorers and innovators are encouraged to be themselves.

We need these people and their distinctive traits– now more than ever. But if we keep dulling the next generation through overmedication, the world (and the individual) won’t see the benefit of their many strengths. We must reject the idea that a successful treatment makes someone “normal”. After all normal means average and what’s so great about that?

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